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Type: Journal article
Title: The influence of unrestricted use of sugammadex on clinical anaesthetic practice in a tertiary teaching hospital
Author: Watts, R.
London, J.
van Wijk, R.
Lui, Y.
Citation: Anaesthesia and Intensive Care, 2012; 40(2):333-339
Publisher: Australian Soc Anaesthetists
Issue Date: 2012
ISSN: 0310-057X
Statement of
R. W. Watts, J. A. London, R. M. A. W. Van Wijk, Y.-L. Lui
Abstract: This retrospective casenote audit involving 374 patients requiring intubation for an anaesthetic found that when the availability of sugammadex became unrestricted, its use increased from 7.1 to 65.3% (P <0.0001) of all muscle relaxant reversals, while neostigmine use decreased from 59.6 to 12.5%. Rocuronium use decreased slightly (90.8 to 79.2%, P=0.006) but vecuronium use increased (2.1 to 8.3%, P=0.02). Cisatracurium and suxamethonium use were unchanged. Total rocuronium dose (55.9 ± 24.1 vs 60.4 ± 22.3 mg) and the number of doses (1.9 ± 1.48 to 1.96 ± 1.27) were unchanged, but the time between the last dose and reversal decreased (91.7 ± 68.1 to 62 ± 52.4 minutes, P=0.0002). There appeared to be no change in postoperative nausea and vomiting, or post-anaesthesia care unit time or oxygen saturation levels. Anaesthetic theatre time fell from 143.5 ± 85.8 to 120 ± 71.2 minutes (P=0.01) and remained significant when adjusted for confounding variables (ratio of means 1.17, 95% confidence interval 1.03 to 1.34, P=0.02), although inferences in relation to causality are limited by the retrospective and observational design of the study. Hospital stay also appeared to fall (4.2 ± 3.5 to 3.4 ± 3.0 days, P=0.035), but was not statistically significant when adjusted for confounding variables (ratio of means 1.04, 95% confidence interval 0.89 to 1.2, P=0.59). These observations suggest that the unrestricted availability of sugammadex will change how steroid-based neuromuscular blocking drugs are used and reversed, but further research is needed to determine if patient outcomes will improve.
Keywords: sugammadex; unrestricted use; rocuronium use; theatre time; hospital stay
Rights: Copyright 2012 Australian Society of Anaesthetists
RMID: 0020118192
DOI: 10.1177/0310057X1204000218
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Appears in Collections:Anaesthesia and Intensive Care publications

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